Usefulness of MR angiography in cases of central vertigo

Syndromal vertigo is defined as a combination of vestibular function disturbance and cranial nerve or cerebral function disturbance. There is evidence that MR angiography (MRA), providing angiogram-like images of the intracranial and extracranial arterial flow, could replace invasive methods for diagnosing central vertigo. The purpose of this study was to provide simplified MRA criteria for identifying morbidity and to analyze the relation between imaging findings and clinical manifestations.

Thirty-three individuals with symptoms of syndromal vertigo and vertebrobasilar territory disease were examined by equilibriometry, MR imaging (MRI) and MRA.

Under MRA, vertebral artery (VA) stenosis was more common than VA occlusion (23 vs. nine cases, respectively). A basilar artery (BA) deviation was found in eight cases (24.2%). Twenty-five VA or BA abnormalities (75.8%) were found, and eight combined VA and BA abnormalities (24.2%) were found.

We emphasize three points as follows. MRA is advantageous over conventional angiography for less invasive method. MRA can reveal abnormalities even in cases of 'solo-vertigo' with no observed neurologic abnormalities. In our series, abnormalities were confirmed by MRA even in cases with no concomitant such as hypertension, coronary heart disease, or diabetes mellitus, which are regarded as latent risk factors for stroke.